138 - Utilization of the Cultural Formulation Interview in a Novel Setting

Objectives:
There is currently no standardized cultural humility training within undergraduate and graduate medical education. In psychiatry, the Cultural Formulation Interview (CFI) was designed to help clinicians understand the impact of culture on a patient’s clinical presentation, diagnosis and treatment. The CFI was found to be feasible, acceptable and clinically useful in patients with mental health disease. We hypothesize that the CFI can be utilized among patients with neurological disease. Successful incorporation of the CFI in neurology can inform use of this tool by clinicians and trainees within other specialties and in medical student education.

Design: A 4th year medical student researcher administered the CFI to eligible patients on the inpatient general neurology and stroke services. Interviews were recorded, transcribed and summarized to the primary treating clinicians. Clinicians and patients subsequently completed demographic questionnaires and debriefing instruments for patients and clinicians (DIP and DIC, respectively) assessing the feasibility, acceptability and clinical utility of the CFI on the neurology service. The medical student debriefed following the first few encounters.

Results: 4 CFI interviews were completed and the DIP, DIC and demographic questionnaires were completed for 2 of those encounters. Debriefing sessions with the medical student following preliminary data collection provided insight into potential application of this tool in medical education and clinical use.

Conclusions: Our initial experience with the CFI demonstrated that a medical student can be trained to administer and utilize this tool. In the first few encounters, the interview revealed unconscious bias with a discrepancy between perceived cultural identity before the interview and the cultural aspects uncovered during the interview. The student felt that this tool may also be applicable to other specialties with long-term care, including PM&R. Incorporation of the CFI into medical school curriculum may provide future clinicians with an additional resource to deliver culturally sensitive care.